Medicine Most Effective in Treating Alcoholism Has Been Largely Ignored for a Decade

Nearly 20 million Americans suffer from alcoholism, but most have never been prescribed medications that can help people with their addictions, a new study shows.

Research based primarily at the University of North Carolina (UNC) found two drugs, naltrexone and acamprosate, which were approved over a decade ago to treat alcoholics, are rarely given to patients with drinking problems. Both medications are designed to adjust a person’s brain chemistry to reduce cravings for alcohol. But previous doubts about the drugs’ effectiveness as well as many physicians being unaware of them have resulted in their underuse, the study concluded.

“These drugs are really underused quite a bit, and our findings show that they can help thousands and thousands of people,” Dr. Daniel E. Jonas, the study’s lead author and an associate professor of medicine at UNC, told The New York Times. “They’re not blockbuster. They’re not going to work for everybody. But they can make a difference for a lot of people.”

Jonas and his colleagues found that the efficacy per patient of naltrexone and acamprosate was higher than that of some drugs developed for other medical conditions. It took 12 people to take acamprosate for one person to stop drinking and 20 people for naltrexone to get the same result. Comparatively, cholesterol-lowering statins, which are widely prescribed, need 25 to more than 100 people to prevent one heart attack or stroke.

The research looked only at the drugs’ use in combination with therapy or counseling. Their efficacy when used alone is not known.

George Koob, director of the National Institute on Alcohol Abuse and Alcoholism, who was not involved in the study, called the research “important.”

“There are effective medications for the treatment of alcoholism, and it would be great if the world would use them,” he told the Times.

The timing of the study is excellent. The Affordable Care Act requires that health plans include treatment for substance abuse and it’s expected that many newly insured people will seek treatment for alcoholism. It is estimated that 18 million Americans suffer from the disease.